Case Report Endovascular single-chamber pacemaker implantation using active fixation in a 8 years old Dogue de Bordeaux with presumed Persistent Atrial Standstill: the first case documented in Romania

Abstract

Background: Symptomatic bradyarrhythmias in dogs can lead to sever hemodynamical compromise due to impaired oxygen and nutrients delivery and even sudden cardiac death. In cases refractory to medical therapy the heart rate and therefore the cardiac output are maintained in physiological ranges using artificial external, internal and temporary (emergency situations) or internal and permanent cardiac pacing.

Methods: This case report documents the implantation of a permanent transvenous Pacemaker using active fixation, for the first time in Romania in a 8 years old canine Dogue de Bordeaux with a suspicion (on surface electrocardiography) of Persistent Atrial Standstill. The diagnostic in this atrial muscular dystrophy requires differentiation from Atrial Fibrillation with Third Degree Atrioventricular Block using Cardiac Mapping, but in emergency situations or progressive Congestive Heart Failure the decision to implant the pacemaker should be based on the hemodynamical effects of the dysrhythmia and the definitive diagnostic should be made during the implantation of the device.

Results: We succesfully implanted in this case a transvenous ventricular Solia S60 lead at the level of the 1/2 distance between the mid-septal and right ventricular apex that was connected to the subcutaneousely placed Pulse Generator (Enitra 6 SR).

The survival after the procedure was 202 days (6 months and 18 days) and the patient's death was not related to a cardiac cause. The necropsy showed that the active fixation in this case was preserved and there were not identified any local rejections of the lead or at the site of the pulse generator.

Conclusions: The outcome of the patient was positive regarding the described cardiac function in this case and the clinical signs went into remission shortly after the pacing.